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Register for the BPT 2021 Lakeland [KLAL] “Hybrid” Clinic”
Take a minute. Take our survey.
Hybrid Clinic Registration Form
Use this form to register for our virtual clinics.
Name
*
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Last
Address
*
Street Address
Address Line 2
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Email
*
Daytime Phone
*
Cell Phone
Sharing your cell phone number with us is important as it may help us communicate with you during a Clinic
Clinic Information
Virtual
Initial and Recurrent Ground School
Friday, February 26, 2021 [9 am to 4 pm ET]
In-person Flight @ Lakeland, FL with a BPT Certified Instructor
Saturday, February 27
8 am – 1 pm ET
1:30 pm – 5:30 pm ET
Sunday, February 28, 2021
8 am – 1 pm ET
1:30 pm – 5:30 pm ET
In-Person “Fly Later” with a BPT Certified instructor
Time and date, TBD at your choosing
How many BPT (or similar) weekend clinics have you previously attended?
Please enter a number from
0
to
30
.
Pilot Registration for BPT Lakeland Hybrid Clinic 2021
*
Online Ground School [$500]
Fly at Lakeland and Online Ground School [$1195]
Fly at local airport and Online Ground School [$995]
Aircraft Information
Aircraft Type
None
33
A33
B33
C33
C33A
E33
E33A
E33B
E33C
F33
F33A
F33C
G33
35
A35
B35
C35
D35
E35
F35
G35
H35
J35
K35
M35
N35
P35
R35
S35
V35
V35TC
V35A
V35ATC
V35B
V35BTC
36
A36
A36TC
B36TC
G36
55
A55
B55
B55A
B55B(T42A)
C55
D55
E55
56TC
58
58P
58TC
G58
95
B95
B95A
D95A
E95A
DUKE 60
Other
Aircraft N#
*
Year aircraft built
Dual Controls?
*
Yes - dual control yoke
No - single control yoke
Turbocharged/Turbonormalized?
Yes
Allison Turboprop?
Yes
What GPS, Autopilot, MFD or other special equipment does your aircraft have?
Are you sharing an aircraft with another attendee? If so please provide his/her name
Please answer the following questions about your flight time
Estimated total time
*
Bonanza time
Baron/Travel Air/Duchess time
Duke time
Are you instrument rated?
*
Yes
No
Pilot Certificate Number
*
Insurance & Documents we must receive from you before your flight:
Certificate of Insurance naming BPT Inc. as an additional insured WITH a waiver of subrogation, and a Hold Harmless Agreement
The above should be sent to our insurance manager:
Pam Bailey
Email:
registrar@pbpt.org
Cancellation Policy
The Online Ground School fee is non-refundable. If you are unable to view the Online Ground School when scheduled, you may watch the recorded video at a later date. When you are assigned an instructor with a flight date and time, your credit card will be charged and is thereafter non-refundable. If you cannot fly at the assigned time, you will have one year to complete a flight.
Phone
This field is for validation purposes and should be left unchanged.